1 Observed walking without help of another person or using support
2 Observed walking with help of another person or using support
3 Not observed - in wheelchair
4 Not observed - bed bound
5 Not observed - uncertain if respondent has impairment

I WOULD LIKE TO TEST WHETHER YOU CAN WALK A VERY SHORT DISTANCE COMFORTABLY. (CAN I JUSTCHECK,) ARE YOU ABLE TO WALK ALONE WITHOUT HOLDING ON TO ANOTHER PERSON (USING A WALKINGSTICK OR OTHER AID IF NECESSARY)?

BLANK / I WOULD NOW LIKE TO TEST WHETHER YOU CAN WALK A VERY SHORT DISTANCE COMFORTABLY(USING A WALKING STICK OR OTHER AID IF NECESSARY). FIRST, I WOULD LIKE TO ASK A FEW QUESTIONS TO CHECK IT IS SAFE TO CARRY OUT THE TEST. DO YOU HAVE ANY PROBLEMS FROM RECENT SURGERY, INJURY,OR OTHER HEALTH CONDITIONS THAT MIGHT PREVENT YOU FROM WALKING?

THIS IS OUR WALKING COURSE. I WANT YOU TO WALK TO THE OTHER END OF THE COURSE AT YOUR USUAL WALKING PACE, JUST AS IF YOU WERE WALKING DOWN THE STREET TO GO TO THE SHOPS. WALK ALL THE WAY PAST THE OTHER END OF THE TAPE BEFORE YOU STOP.INTERVIEWER: DEMONSTRATE THE WALK FOR THE RESPONDENT.(I WILL WALK WITH YOU.) DO YOU FEEL THIS WOULD BE SAFE?

WHEN I WANT YOU TO START, I WILL SAY: 'READY, BEGIN!'INTERVIEWER: ASK THE RESPONDENT TO STAND WITH BOTH FEET TOGETHER AT THE START OF THE WALKING COURSE. WHEN THE RESPONDENT IS PROPERLY POSITIONED AT THE START OF THE WALKING COURSE, SAY: 'READY, BEGIN!' PRESS THE START / STOP BUTTON TO START THE STOPWATCH AS THE RESPONDENT'S FOOT HITS THE FLOOR ACROSS THE STARTING LINE. IF POSSIBLE WALK BEHIND AND TO THE SIDE OF THE RESPONDENT. STOP TIMING WHEN THE RESPONDENT'S FOOT HITS THE FLOOR AFTER THE END OF THE WALKING COURSE.ENTER 1 TO CONTINUE.

1..1

MMTRYA

INTERVIEWER: Record results of first trial.Enter time at next question.

I WOULD LIKE TO TEST WHETHER YOU CAN WALK A VERY SHORT DISTANCE COMFORTABLY. (CAN I JUSTCHECK,) ARE YOU ABLE TO WALK ALONE WITHOUT HOLDING ON TO ANOTHER PERSON (USING A WALKINGSTICK OR OTHER AID IF NECESSARY)? - - - - - - - - - - - - - - - - - - - - - - - - - 1 Yes
2 Yes but aid unavailable
3 No

| If INTERVIEWER: Record respondent status. (MMSCHS) = 1 Observed walking without help of another person or using support or I would like to test whether you can walk a very short distance comfortably. (MMALONE) = 1 YesTHEN

BLANK / I WOULD NOW LIKE TO TEST WHETHER YOU CAN WALK A VERY SHORT DISTANCE COMFORTABLY(USING A WALKING STICK OR OTHER AID IF NECESSARY). FIRST, I WOULD LIKE TO ASK A FEW QUESTIONS TO CHECK IT IS SAFE TO CARRY OUT THE TEST. DO YOU HAVE ANY PROBLEMS FROM RECENT SURGERY, INJURY,OR OTHER HEALTH CONDITIONS THAT MIGHT PREVENT YOU FROM WALKING? - - - - - - - - - - - - - - - - - - - - - - - - - 1 No apparent restriction
2 Yes, Recent surgery
3 Yes, Injury
4 Yes, Other health condition

| | If Do you have any problems from recent surgery, injury,or other health conditions that might prevent you from walking? (MMHSS) = 1 No apparent restriction »

| If Do you have any problems from recent surgery, injury,or other health conditions that might prevent you from walking? (MMHSS) = 2 Yes, Recent surgery or Do you have any problems from recent surgery, injury,or other health conditions that might prevent you from walking? (MMHSS) = 3 Yes, Injury or Do you have any problems from recent surgery, injury,or other health conditions that might prevent you from walking? (MMHSS) = 4 Yes, Other health condition »

THIS IS OUR WALKING COURSE. I WANT YOU TO WALK TO THE OTHER END OF THE COURSE AT YOUR USUAL WALKING PACE, JUST AS IF YOU WERE WALKING DOWN THE STREET TO GO TO THE SHOPS. WALK ALL THE WAY PAST THE OTHER END OF THE TAPE BEFORE YOU STOP.INTERVIEWER: DEMONSTRATE THE WALK FOR THE RESPONDENT.(I WILL WALK WITH YOU.) DO YOU FEEL THIS WOULD BE SAFE? - - - - - - - - - - - - - - - - - - - - - - - - - 1 Yes
2 No

WHEN I WANT YOU TO START, I WILL SAY: 'READY, BEGIN!'INTERVIEWER: ASK THE RESPONDENT TO STAND WITH BOTH FEET TOGETHER AT THE START OF THE WALKING COURSE. WHEN THE RESPONDENT IS PROPERLY POSITIONED AT THE START OF THE WALKING COURSE, SAY: 'READY, BEGIN!' PRESS THE START / STOP BUTTON TO START THE STOPWATCH AS THE RESPONDENT'S FOOT HITS THE FLOOR ACROSS THE STARTING LINE. IF POSSIBLE WALK BEHIND AND TO THE SIDE OF THE RESPONDENT. STOP TIMING WHEN THE RESPONDENT'S FOOT HITS THE FLOOR AFTER THE END OF THE WALKING COURSE.ENTER 1 TO CONTINUE. - - - - - - - - - - - - - - - - - - - - - - - - - 1..1

| If INTERVIEWER: Record results of first trial.Enter time at next question. (MMTRYA) = 1 Completed successfully or INTERVIEWER :Record result of second trial.Enter time at next question. (MMTRYB) = 1 Completed successfully »

| If INTERVIEWER: Record results of first trial.Enter time at next question. (MMTRYA) = 1 Completed successfully and INTERVIEWER :Record result of second trial.Enter time at next question. (MMTRYB) = 1 Completed successfully »